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WCYPB 2011 INVITATIONAL TEAM AFFIDAVIT

MANAGER NAME: NUMBER:

EMAIL ADDRESS:DIVISION: TEAM NAME:

INSURANCE CO.: POLICY #:

Uni # Player's Full Name Birth date Address City

12 John David Doe 09/09/1993 123 Anystreet Road Anytown

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2011 WCYPB INVITATIONALTOURNAMENT APPLICATION

MANAGER NAME:

TELEPHONE #:

EMAIL:

DIVISION:

TEAM NAME:

PLEASE REMIT PAYMENT TO:

WCYPB INVITATIONAL

P.O. BOX 5201WEST COVINA, CA 91791

TOURNAMENT CONTACT: ALEX CHAVEZlxchavez@gmail.com626.483.2995